BILINGUAL & ASD REPORT – MARCH 2018 1
Bilingual Development in Children with Autism Spectrum Disorder
from Newcomer Families
March 2018
Authors Research Partners
Johanne Paradis Krithika Govindarajan
Keren Hernandez Dept of Linguistics, University of Alberta
Multicultural Health Brokers Cooperative
Edmonton Public Schools
Edmonton Catholic Schools
Centre for Autism Services Alberta
BILINGUAL & ASD REPORT – MARCH 2018 2
Summary
The home language environment and language abilities were compared between children with ASD and
children with typical development, both from newcomer families. Children were in elementary school, mostly
6 and 7 year olds. The goal was to understand if there were differences in bilingual development between
children with ASD and children with typical development the same age. Specifically, we wanted to
understand if children with ASD have the capacity to become bilingual and whether this is supported by
their communities, clinicians and educators. Key findings were as follows: Parents of children with ASD
were often advised to use only or more English with their child, by friends as well as professionals. Children
with ASD started to learn English at a younger age than the children with typical development and had
much more exposure to English through preschool attendance and intervention. Children with ASD heard
and spoke more English, and less of their heritage language, at home than the children with typical
development. Regarding English abilities, the high verbal children with ASD had similar abilities to the
children with typical development. In contrast, the high verbal children with ASD had lower abilities in their
heritage language than the children with typical development. We conclude that children with ASD are
more at risk than children with typical development for losing their heritage language. In other words,
children with ASD have the capacity to be bilingual, but have limited opportunities to develop their heritage
language. We end with recommendations for better supporting bilingual development in children with ASD
from newcomer families.
Background
What is Autism Spectrum Disorder?
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder, which means children are born with
this disorder. Children with ASD are usually delayed in their language development in the preschool years
and their language abilities vary a great deal in later years. Some children with ASD develop language
skills very close to their neurotypical peers while other children have low verbal abilities that persist.
Children with ASD have life long deficits in social interaction and communication and they also exhibit
restricted interests and repetitive behaviours.
Bilingualism and ASD
When a child is diagnosed with Autism Spectrum Disorder (ASD), it can be very difficult for parents. They
might struggle emotionally, have concerns about their child’s future, have many questions about
intervention services and wonder how they should use language in conversations with their child at home.
For newcomer families, questions also arise about which language to use with their child because, typically,
there is a heritage language spoken at home – the child’s first language - and there is also the societal
language, English, that is the child’s second language. Because difficulties with language and
communication are both implicated in ASD, this raises concerns about bilingualism for children with ASD.
Parents and health practitioners often ask whether children with ASD are capable of learning two languages
and becoming bilingual, or whether it would be better for that child’s overall language development to only
hear and speak one language.
BILINGUAL & ASD REPORT – MARCH 2018 3
Importance of learning the heritage language and culture
Children from newcomer families can benefit in many ways from growing up speaking the heritage language.
Children who can speak the heritage language can communicate more easily with their parents, who often
are not fluent in English. Children who can understand the heritage language can participate fully in cultural
events, deepen their understanding of their heritage culture and better develop an identity as a member of
their cultural community. Learning the heritage language alongside English does not take away from
children’s long-term success in English, and in fact, bilingualism can confer some advantages in thinking
skills and in learning to read. Bilingualism could open doors to educational and employment opportunities
in the long term as well.
For children with neurodevelopmental disorders like ASD, communication and closeness with parents is
even more vital than for their neurotypical peers. This is because parents are often companions and
caregivers even when children reach adolescence. Therefore, continuing to learn the heritage language
after diagnosis would have benefits for children with ASD.
Research Goals and Methods
The goal of this research was to examine the language abilities and home language learning environment
of bilingual children with ASD and bilingual children with typical development, both from newcomer families.
We wanted to examine the capacity for bilingualism in the children with ASD, the support for bilingualism
surrounding them, and whether their home language environments were different from other bilingual
children.
School-age children were visited in their homes and their English language abilities were measured.
Researchers recorded children’s language while playing with them and while asking them to tell a story
from a book. Children were also given a test to measure how many words they know in English. Some of
the children with ASD had low verbal abilities, and so were not able to complete all these tasks. Researchers
also gave a questionnaire as an interview to a parent, usually the mother. Parents were asked about their
children’s abilities in the heritage language and about their early language development. Parents were also
asked about how much English versus the heritage language is spoken in the home among family members.
Parents of children with ASD were also asked about what advice and support they have been given about
raising their child bilingually after diagnosis and whether this had changed what language(s) they used with
their child.
BILINGUAL & ASD REPORT – MARCH 2018 4
Children and their Families in this Research
The two groups of children were similar in size, age, mothers’ level of education, mothers’ fluency in English,
and heritage language/cultural backgrounds, as shown in Table 1 below. The children with ASD were
diagnosed, on average, at slightly younger than 4 years (45 months). The children with ASD displayed a
wide range of verbal abilities, but we placed them into two categories (high verbal and low verbal) based
on what other researchers have done. The high verbal children (11/31) were those who could complete all
our expressive language tasks and who could converse spontaneously with the researchers, demonstrating
turn-taking skills. The low verbal group (20/31) included children who could participate in some tasks but
did not produce much spontaneous speech and demonstrated echolalia. The low verbal group also included
children who did not speak at all during our visit.
Table 1. Characteristics of the Participants
Bilinguals with ASD Bilinguals with Typical Development
Number of children 31 33
Age 85 months 81 months
Mother’s education Most have post-secondary Most have post-secondary
Mother’s fluency in English 2.29 / 4 2.39 / 4
Heritage language / culture Amharic Arabic Cantonese Karen Mandarin Punjabi Sinhala Sindhi Spanish Urdu
Arabic Cantonese Hindi Mandarin Pashto Punjabi Spanish Urdu
Age of ASD diagnosis 45 months
N/A
Note: Age, Mother’s fluency in English and Age of ASD diagnosis are group averages
BILINGUAL & ASD REPORT – MARCH 2018 5
Key Research Findings
Advice to parents of children with ASD and support for children’s bilingualism
Roughly half the parents of children with ASD reported that they had been given advice, by a healthcare
professional, teacher or a friend, to switch to using only English with their child (16/30 families; because
two of the children in the study were siblings, the total number of families is 30, not 31). Seven families
decided to use primarily English at home with their child. The rest of the families used some combination
of the heritage language and English at home, but the majority of these families reported using more English
than the heritage language. Parents reported that their choice to use more English was influenced by
professional advice, advice from friends, concern that their child would get confused, and desire for
consistency between the intervention and school language and the home language. Parents reported that
their choice to continue to use the heritage language was motivated by “naturalness” in communicating with
their child, communication needs among extended family members, lack of proficiency in English and belief
in their child’s capacity for bilingualism. Importantly, only 8 families said that their use of the heritage
language at home remained unchanged after diagnosis. A few families reported trying to switch to using
English, but returned to speaking their heritage language. Regarding language intervention materials
provided to parents by therapists, 23/30 said these materials were only in English. The other 7 parents
reported that they were encouraged to adapt the materials themselves to the heritage language, or some
materials were provided in the heritage language. Finally, many families expressed a desire to know more
about how bilingualism will affect their child’s development. Examples of parent responses are in Table 2
below.
In summary, these qualitative interviews point to some pressure being given to parents to use only English
or more English with their children. The pressure is coming not only from clinicians and educators but also
from friends who are members of their communities and the parents themselves. Although the majority of
parents did not comply with using only English, it appears that most parents used more English than the
heritage language and had little choice but to conduct home intervention activities in English.
BILINGUAL & ASD REPORT – MARCH 2018 6
Table 2. Examples of parent responses from the interviews
Theme Parent Responses
Advice on Language
Use
The paediatrician said the child was confused with 2 languages. The mother was advised to use just English since she lived in Canada. The SLP said that she didn’t ‘think’ using two languages would affect his language. Because the SLP used [the word] ‘think’ – [it] was not convincing enough for the mother, so she chose to go with the paediatrician's recommendation and speak only English despite her poor proficiency in the language.
Other parents have said that it is best to speak one language to simplify the language environment.
It [using more English] was suggested by the daycare, and also, the extended family advised using more English with the child.
When the child received his diagnosis, his SLP recommended using English, but the mother chose to speak Spanish.
Their doctor told them to continue using both languages because even if the child wasn't expressing himself, he was still building the languages in his head.
A therapist used Punjabi with the child at the preschool program. The mother has always been told to use both languages.
“A few of the SLPs recommended I speak English but that I didn’t have to do it. But there was one therapist I placed a lot of trust and she told me to continue speaking Spanish. She said she came from an immigrant family, somewhere in Europe, and she had a lot of experience working with children with autism. She recommended we speak Spanish and not English because my children were going to learn English anyway and there would be no interference. And that is what we chose to do."
Decisions about
language use
Family ignored English-only advice and emphasized bilingualism. Mother prefers to use the Amharic during play but sometimes uses English. She feels using Amharic is easier for her and also she feels it is beneficial.
Parents don't feel that the child needs to be bilingual as long as he can communicate in English. Even in their home country, they would have paid expensive tuition fees so their child could learn to speak English.
Mother responded that it is hard for her [to use English] but not for her son. Sometimes he understands more English than Karen and sometimes she doesn't understand what he says.
Mother said it is not natural for her to use English. She finds it more meaningful to say "I love you" in Spanish. Using Spanish [allows her to] teach her son the right way to speak in Spanish. She doesn't feel confident teaching him grammar in English. She is okay with him learning English properly at school but at home he needs to speak Spanish.
Family was in complete disagreement about using only English. "Some people in the family only speak Punjabi. How about when we travel back to India?"
Mother speaks Hindi because she wants her son to be connected to his culture and to communicate with his cousins.
Before the child’s diagnosis, they used Mandarin. After receiving the diagnosis, they decided to use only one language. The family made a decision to speak in English.
Because the parents live in Canada, they speak more English in general. Also, the aides who come every day speak English, so they also copy the aides. They use more English with their son (who has ASD) than with their daughter.
After the diagnosis, the mother felt that using only English wouldn't confuse him and that it would prepare him better for school. Initially, the family felt worried that the child would be confused if two languages were used. Eventually, the family decided that it felt more natural to use both Mandarin and English.
“They give me the therapy and they give me the tools, but what language to speak is something I’m choosing to do and sometimes I question myself whether I’m harming or interfering with their [children’s] language development. Maybe certain objectives won’t be seen in the time they are supposed to because I’m speaking another language? I would have liked to know then what I know now. My children are definitely capable of learning two languages."
BILINGUAL & ASD REPORT – MARCH 2018 7
Children’s language learning environments
The children with ASD started to learn English at a younger age (40 months – 3 ½ ) than the children with
typical development (TD; 56 months – 4 ½ ). When our research started, the children with ASD had nearly
twice as many months of learning English (46 months – almost 4 years) than their peers with TD (24 months
– two years). Both differences are statistically significant. The early diagnosis of ASD followed by intensive
therapy and participation in preschool programming increased the total amount of English exposure for the
children with ASD.
Figure 1. Comparison between children with ASD and children with TD for exposure to English
We asked parents questions about language use among family members. We asked what language family
members spoke to the child and what language the children spoke to family members. Answers followed
this rating scale:
0
English never
Heritage Language
always
1
English seldom
Heritage language usually
2
English 50%
Heritage language 50%
3
English usually
Heritage language seldom
4
English almost always
Heritage language
almost never
0
10
20
30
40
50
60
Age (months) when started learning English Total months of learning English
ASD
TD
BILINGUAL & ASD REPORT – MARCH 2018 8
Children with ASD heard statistically significantly more English from their mothers than the children with TD
(Figure 2 below). Children with ASD heard slightly more English from their fathers and their siblings, but
the difference with the TD group was not statistically significant. When we looked at families where the
child’s mother spoke English almost always (point 4 on the rating scale above), we only found 1 family in
the ASD group and 1 family in the TD group. Thus, even though children with ASD were hearing more
English at home than children with TD, both groups of children were hearing some of their heritage language
at home.
Figure 2. Average rating scale scores for languages spoken to the child at home, for the ASD and TD
groups. 0 means the heritage language is spoken always and 4 means English is spoken almost always
Regarding what language the child speaks with family members, children with ASD spoke statistically
significantly more English to their mothers and their fathers than the children with TD (Figure 3 below).
Children with ASD spoke slightly more English to their siblings, but the difference with the TD group was
not statistically significant. When we looked at families where the child spoke English almost always, (point
4 on rating scale), we found only 1 family in the TD group, but there were 9 families in the ASD group who
reported this. Thus, the children with ASD were speaking more English at home than the TD children and
some children with ASD were speaking English at home almost always.
0 0.5 1 1.5 2 2.5 3 3.5 4
Mother to Child
Father to Child
Siblings to Child
TD ASD
BILINGUAL & ASD REPORT – MARCH 2018 9
Figure 3. Average rating scale scores for languages the child speaks at home, for the ASD and TD groups.
0 means the heritage language is spoken always and 4 means English is spoken almost always
Children’s abilities in English and in their heritage language
To compare children’s abilities in English, we examined their scores on the Peabody Picture Vocabulary
Test – a test that measures how many word they know in English. We also compared how long their
sentences were and how many different words they used when playing with the researchers. For the
children with ASD, only the children who completed these activities are included here (22/31). Results are
reported for all the children with ASD who completed the tasks (22) and for the children who were high
verbal (10) separately. See Table 3 below.
The children with ASD had statistically significantly lower scores for vocabulary knowledge and shorter
sentences than the TD children. The children with ASD produced fewer different words than the TD children,
but this difference was not statistically significant. Because children with ASD have difficulties learning
language, we did not expect the entire group of children with ASD to have English abilities equal to the
children with TD. But, when the high verbal children with ASD were examined separately, there were no
significant differences between them and the TD children for vocabulary scores and sentence length. Thus,
the high verbal children with ASD were able to catch up in English to bilingual neurotypical children the
same age.
For the heritage language, we examined parent report on the child’s early language development and
current abilities in the heritage language. The children with ASD were more likely to have language delay
in the early years, both the entire group and the high verbal children, than the TD children, as expected.
The scores for current abilities in the heritage language were statistically significantly lower for both groups
of children with ASD when compared to the children with TD. Thus, the high verbal children with ASD were
not able to maintain their heritage language as well as bilingual neurotypical children the same age.
0 0.5 1 1.5 2 2.5 3 3.5 4
Child to Mother
Child to Father
Child to Siblings
TD
ASD
BILINGUAL & ASD REPORT – MARCH 2018 10
Table 3. Comparing English and Heritage Language Abilities
Bilinguals with ASD – all who
completed task
Bilinguals with ASD – high
verbal
Bilinguals with TD
Description
English vocabulary size
66 81 83 Average for
monolinguals this age = 100
English sentence length
2.8 words 4.0 words 3.8 words Average length in 15 minute play session
Number of different words
spoken in English
130 219 149 In 15 minute play
session
Early language development on
time?
52 58 93 Range: 0 = severely delayed to 100 = on
time
How well does the child speak the
heritage language?
30
33 65
Range: 0= no
proficiency to 100 = highest proficiency
BILINGUAL & ASD REPORT – MARCH 2018 11
Conclusions and Recommendations
Conclusion # 1: Bilingual Capacity
All of the children with ASD could understand English and, of those who were verbal, they could speak
English. Most children with ASD in this study could understand their heritage language to some extent
and, of those who were verbal, they could speak it to some extent. The children with ASD who were high
verbal were able to catch up to neurotypical bilingual children the same age in their English abilities.
Recommendation:
• Children with ASD have the capacity to be bilingual into the elementary school years.
Advice to parents to restrict bilingualism for children with ASD is not supported by
evidence.
Conclusion # 2: Home Language Use
It is common for parents to be advised to speak only or mainly English with their child after an ASD
diagnosis. The majority of parents used more English than the heritage language with their child during
the elementary school years and had to do home intervention activities in English.
Recommendations:
• There is a need to raise awareness in newcomer communities and among clinicians and
educators regarding encouragement and support for bilingualism in children with ASD.
• Parents would especially benefit from assistance in adapting home intervention activities
into the heritage language and culture.
Conclusion # 3: Language Abilities
Children with ASD started to learn English at an earlier age than children from newcomer families with
typical development (TD). By the elementary school years, children with ASD had twice as much English
exposure as the TD children. At home, children with ASD heard more English and spoke more English
than the TD children. Both high verbal and low verbal children with ASD had had lower abilities in their
heritage language than their bilingual age peers with TD. Bilingual children with ASD are at greater risk
than their peers with TD for losing their heritage language as they grow older.
Recommendation:
• Children with ASD need additional support for their heritage language development to
counteract how much exposure they have to English.
Take-Home Message
Children with ASD struggle to maintain the heritage language because of early exposure to English, more
exposure to English through intervention, more use of English and less use of the heritage language at
home. In other words, the greater risk of losing the heritage language is not because children with ASD
are incapable of bilingualism, it is because they are not getting the opportunity to become bilingual.
BILINGUAL & ASD REPORT – MARCH 2018 12
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